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Low Carb Sausage Meatball Casserole

This sausage meatball casserole is comforting and delicious! A low carb, keto, and gluten free recipe.
Course Main Course
Cuisine American
Prep Time 10 minutes
Cook Time 40 minutes
Total Time 50 minutes
Servings 4
Calories 473kcal
Author Georgina from


  • 1 lb sausage meat
  • salt and black pepper
  • 1 tbs oil
  • 4 oz sliced mushrooms
  • ½ tsp minced garlic or garlic paste
  • 14.5 oz (411g) canned diced tomatoes
  • 6 oz fresh baby spinach
  • ¾ cup shredded cheese divided
  • fresh parsley to garnish optional


  • Preheat the oven to 350F.
  • Make the sausage meatballs by combining the sausage meat with salt and black pepper in a bowl. Form the meat into about 24 small balls.
  • Add the oil to a large skillet and fry the sausage meatballs until browned all over.
  • Transfer them to a baking dish, then use the leftover oil to fry the mushrooms and garlic. After the mushrooms have softened, add the can of tomatoes and baby spinach, then continue to cook until the spinach has wilted.
  • Stir in ½ cup of the shredded cheese, then test for seasoning, adding salt and pepper if necessary. Transfer everything to the baking dish using a slotted spoon, then mix in with the meatballs.
  • Roast for 15 minutes, then sprinkle the remaining cheese over the top. Continue to bake until the cheese has melted.
  • Garnish with parsley, if using.


5g net carbs per serving (quarter of recipe, approx 6 meatballs per person)


Calories: 473kcal | Carbohydrates: 7g | Protein: 24g | Fat: 38g | Saturated Fat: 13g | Cholesterol: 98mg | Sodium: 1034mg | Potassium: 817mg | Fiber: 2g | Sugar: 3g | Vitamin A: 4335IU | Vitamin C: 22.9mg | Calcium: 190mg | Iron: 3.6mg